Managing the side effects of immunotherapy

The side effects of checkpoint immunotherapy are different from other cancer treatments. Not everyone will experience the same side effects, and some people may have no side effects. The side effects can vary depending on the type of immunotherapy you receive and how your body responds.

Since your immune system takes care of your whole body, immunotherapy can cause inflammation in any of the organs in the body. This can mean that some people with an autoimmune disease such as lupus or rheumatoid arthritis may find it difficult to have immunotherapy safely. Discuss this with your doctor if you have an autoimmune disease.

Common side effects include fatigue, skin rash and diarrhoea – which can vary in severity and duration.

Side effects are likely to be more severe if you are taking a combination of immunotherapy drugs or having immunotherapy with other cancer treatments.

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Let your doctor know about side effects
As immunotherapy works differently from other cancer treatments, it’s important to work closely with your doctor to monitor your response.

Before immunotherapy starts, discuss the specific side effects you may experience with your doctor. Ask your doctor or nurse which side effects to watch out for or report, and who to contact after hours.

During treatment, let your medical team know about any side effects you experience. Side effects can be better managed when they are reported early. If they are not treated, side effects may become serious, and treatment may need to be stopped until the side effects are better controlled. Occasionally, immunotherapy must be stopped permanently if the side effects are too severe.

Side effects of immunotherapy

immunotherapy side effects

Managing the side effects of immunotherapy

Side effects can sometimes begin within days of starting treatment, but more commonly they occur weeks or even months after starting treatment.

In some rare cases, they can occur after treatment has ended. Work with your doctor to develop a plan for how long to look out for potential side effects.

To manage the side effects, it is important to let your health care team know about new symptoms. Even if you are experiencing side effects, you can continue to benefit from immunotherapy.

Side effects will be graded to help decide how to treat them.

Moderate and severe side effects – These are often treated with steroids such as prednisone.

Severe side effects – In some cases, people may need to be hospitalised or treated with high doses of steroids if side effects are severe. Side effects often improve with treatment, but sometimes they can be serious and people will be unable to continue immunotherapy.

Click on the icon below to download a PDF booklet on Immunotherapy.

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Apple devices

The iBooks application must be installed on your Apple device before you can read the EPUB.
Different ways to download an EPUB file to your Apple device:

  • email EPUB files to yourself and transfer the attachment to iBooks.
  • copy EPUB files into DropBox (or a similar service) and use the DropBox app to send them to iBooks.
  • open EPUB files directly from Mobile Safari and open them in iBooks, where they are saved automatically by downloading the EPUB from the website.

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To download an EPUB file to your Kobo from a Windows computer:

  • download and save the EPUB directly onto your desktop.
  • connect your Kobo to your computer using the USB cable and tap “Connect” on your eReader.
  • select “Open folder to view files” to view the contents of your Kobo.
  • navigate to where you have stored your EPUB file in “Finder”, in documents or downloads, and drag and drop it into the Kobo window. You can now disconnect your Kobo to read the eBook.

To download an EPUB to your Kobo from a Mac:

  • download and save the EPUB directly onto your desktop.
  • connect your Kobo to your computer using the USB cable and tap “Connect” on your eReader.
  • open your “Finder” application.
  • select “Kobo eReader” from the listed devices to view the contents of your Kobo.
  • navigate to where you have stored your EPUB file in “Finder”, probably in documents or downloads, and drag and drop it into the Kobo window. You can now disconnect your Kobo to read the eBook.

Turn on your Kobo and your EPUB will be located in “eBooks”, while a PDF will be located in “Documents”.
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Sony Reader

To download an EPUB file on your Sony Reader™:

  • ensure you have already installed the Reader™ Library for PC/Mac software
  • select the eBook you want from our website and click the link to download it.
  • connect the Reader™ to your computer.
  • open the Reader™ Library software and click “Library” in the left-hand pane and select the eBook to view it.

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Amazon Kindle 2nd Generation devices

EPUB files can’t be read on the Amazon Kindle™. However, like most eReaders, Kindle™ 2nd Generation devices are able to display PDFs. We recommend that you download the PDF version of this booklet if you would like to read it on a Kindle™.
To transfer a PDF to your Kindle™ via USB cable from your computer or Mac:

  • download the PDF directly onto your computer.
  • connect the USB cable to your computer’s USB port, and the micro USB end of the cable to your Kindle™. Note: the Kindle™ won’t be available as a reading device while it is connected to your computer until it has been disconnected.
  • open the Kindle™ drive and several folders will appear inside. The “Documents” folder is where you will need to copy or drag the PDF to.
  • safely eject your Kindle™ from your computer and unplug the USB cable. Your content will appear on the Home Screen.

Kindle also provides a Kindle Personal Documents Service that allows users to send documents as an attachment directly to your eReader. For more information on this service, visit
For more information on accessing a PDF on your Kindle™, visit, log in to your account and click on Personal Document Settings.
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Android and PC

You can also download and open eBooks on Android devices and PCs with appropriate apps or software installed. Suitable eReader apps for Android include Google Play Books, FBReader and Moon+ Reader. Suitable software for PCs include Calibre and Adobe Digital Editions.

This information was last reviewed in June 2017
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